The changes in tubular fluid flowdue to glomerular hyperfiltration and decreased renal mass may lead to expression of the molecules in proximal tubular cells. We aimed to investigate the urine levels of netrin-1, neutrophil gelatinase-associated lipocalin (NGAL) and C-C motif chemokine ligand-2 (CCL-2) as potential urine biomarkers in children with multicystic dysplastic kidney (MCDK).

Material and methods:

Thirty two patients and 25 control were included in this study. Urine albumin, creatinine and protein levels were measured in the spot urine samples. The urine netrin-1, NGAL and CCL-2 levels were determined by using ELISA.The results were expressed as netrin-1/creatinine (Cr), CCL-2/Cr and NGAL/Cr.

Results:

The patients had higher serum creatinine levels, urine albumin/creatinine ratio (ACR) and netrin-1/Cr ratio, and lower eGFR than in control group (p=0.031, p=0.037, p=0.04, respectively). The urine NGAL/Cr and CCL-2/Cr were similar between patients and control group (p>0.05). Urine CCL-2/Cr was positively correlated with spot urine protein/creatinine (r=0.387, p=0.031). There was a positive correlation between urine netrin-1/Cr and urine CCL-2/Cr (r=0.356, p=0.045). Eleven patients (34.4%) had proteinuria. The patients with proteinuria had higher urine NGAL/Cr levels than in non-proteinuric patients [0.22 (0.19-0.42) / 0.17 (0.09-0.34) ng/mg Cr, respectively, p=0.034].

Conclusions:

The urine netrin-1 may reflect the changes in proximal tubule before the markers of known proximal tubule function are affected in children with MCDK. The higher levels of urine NGAL probably may be a biomarker of theproximal tubule damage by proteinuria.